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NPI Code Detail

MEDICARE: IREDIA KENNETH ODIGIE

MEDICARE: IREDIA KENNETH ODIGIE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WP0808XPsychiatric/Mental Health Registered Nurse95207705CA

General Provider Information

NPI Number : 1811840697
Entity Type Code : Individual
Provider Name (Legal Business Name) : IREDIA KENNETH ODIGIE
Provider Business Mailing Address
First Line : 4221 FLOYD CT SE
Second Line :
City : SALEM
State : OR
Zip : 97317-5438
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 720 WOOD ST
Second Line :
City : EUREKA
State : CA
Zip : 95501-4413
Country : US
Telephone Number : 707-268-2990
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/19/2026
Last Update Date : 02/20/2026

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Directions to “ IREDIA KENNETH ODIGIE ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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